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Right Place In The First Place - An EMS PI Initiative
*Tiffany Taylor, *Joshua Dugal
SSM Health Cardinal Glennon Children's Hospital, St. Louis, MO

Purpose: - The purpose was to increase the number of critically injured children presenting via EMS directly to a Pediatric Trauma Center. Relevance/Significance: The earlier trauma patients can get to a tertiary care center, the higher the likelihood of improved outcomes, especially with injured pediatric patients. Strategy and Implementation: In 2018, registrars began to expand who received follow up letters. They would not only send letters to the air agency/crew that flew the patient to us, they also would send the letters to the ground EMS service. In 2019, registrars began to track in the registry when a patient bypassed another facility to come directly to us. From this information, the trauma coordinator writes personalized letters to both the crew members of the ground EMS agency as well as the air crew. These letters focus on the importance of timely evaluation at a Pediatric Trauma Center. Evaluation/Outcomes:. We looked at all Class 2 activations with an ISS >15. We focused on this group to show patients who were “stable” enough to go to an outside facility, but critically injured enough to require specialized care. With the initiation of our intervention in 2018, there was a 25% increase in patients that were brought directly to the hospital in 2019. With the initiation of the hand-written letter in 2019, the number directly from the scene increased from 5 to 15, a 200% increase. Implications for Practice: This project shows that personalized, closed-loop communication with not only the Air EMS Service but also the Ground EMS service can improve outcomes for pediatric trauma.


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